Visual Function, Physical Function, and Activities of Daily Living in Two Aging Communities

PURPOSE: We report the distribution of visual acuity impairment (VAI), contrast sensitivity impairment (CSI) and their associations with physical health in an aging population. METHODS: In this cross-sectional analysis, VAI was categorized as mild (20/40–20/60) and moderate or greater (<20/60) in the better eye for distance and near vision. CSI was categorized as moderate (1.04–1.50 logCS) and severe or profound (<1.04 logCS). Physical outcomes included the short physical performance battery (SPPB) scores, self-reported quality of life (QoL) scores, physical limitations, difficulty with activity of daily living (ADL) and instrumental ADL (IADL). The associations between VAI and CSI with physical outcomes were explored overall and by community. RESULTS: There were 494 Black Jackson and 558 White Washington County participants. The mean age was 80 years, 63% were female, and 15% had VAI(distance presenting). Moderate or greater VAI(near presenting) was associated with higher prevalence of greater physical limitations (prevalence ratio, 1.25; 95% confidence interval, 1.09–1.44) and IADL difficulties (prevalence ratio, 1.77; 95% confidence interval, 1.32–2.38), but not ADL difficulties. Associations of VAI(distance presenting) with physical limitations and lower SPPB scores, and CSI with physical limitations, IADL difficulties, lower QoL, and lower SPPB scores were found. A stratified analysis showed stronger associations in Jackson. CONCLUSIONS: VAI and CSI were associated with poor physical health. These associations should be understood in the context of community differences. TRANSLATIONAL RELEVANCE: Community-based factors may mitigate the impact of vision loss on physical outcomes. Public health endeavors are needed to address VAI and CSI to optimize physical health in the older adults with poor vision.